Developer API – British Columbia
MDBilling.ca allows for 3rd party software developers to integrate and build on our proven platform. If you are a software developer, you can save time and focus on your business by leveraging our proven MSP billing platform. You can integrate MDBilling.ca to your application very easily through the MDBilling.ca API. Add patients, create new claims, and claim data with a few simple web requests. The MDBilling.ca API is a RESTful service that uses JSON as the data format using an HTTPS connection. Sample use cases are:
- Focus on your EMR software application, not on the continuous changes with MSP standards.
- Faster time to market on your core business
- Reduce development costs.
OVERVIEW: Managing subscriptions accounts with the MDBilling.ca API has the same functionality available in the GUI web interface:
- Create/update patient records
- Create/update claim records
- Retrieve claim rejection and payment report information
- Submit claims to MOHLTC through EDT using our back-end process.
REQUESTING ACCESS: API access can be requested by contacting us at [email protected]
All API access is customized to our client’s requirements.
REQUEST URL: All communications with our API use SSL encryption. Unencrypted HTTP connections are not allowed. The base API URL is as follows:
/API/
Each request requires the username and password as part of the request header. Additionally, all requests require a mdbilling.ca assigned Token Id.
TEST API:MDBilling.ca will provide a test API that can be used for client applications to test changes to their system. Upon successful signup, mdbilling.ca will send the test API URL.
AUTHENTICATION: We authenticate via Basic access Authentication through username/password. The username and password must be sent as part of the HTTP request header in the following format which must then be base 64 encoded:
username:password
As an example, if the username and password were:
john.doe:abc123
The base 64 encoded string would be:
“Authorization: Basic am9obi5kb2U6YWJjMTIz ”
RESPONSE FORMAT: MDBilling.ca API requests use HTTP/JSON. For more information about this standard, please refer to the following links:
http://en.wikipedia.org/wiki/JSON
API REQUEST DICTIONARY: All of our API requests are customized to our client’s requirements. The dictionary below is a sample that may be applicable to you.
CreatePatient Back to Request Dictionary
Type: POST
URL: /PatientAPI/CreatePatient
Description: Creates a new patient. The patient created must have a unique health card number and must not already exist.
Request Definition:
sdsd
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | Description | Subtotal: | $1.00 |
| BillingNumber | Description | Subtotal: | $1.00 |
| FirstName | Description | Subtotal: | $1.00 |
| LastName | Description | Subtotal: | $1.00 |
| HealthCardNumber | Description | Subtotal: | $1.00 |
| PaymentProgram | Description | Subtotal: | $1.00 |
| VersionCode | Description | Discount: | $2.00 |
| Province | Description | Shipping: | $3.00 |
| Gender | Description | Tax: | $4.00 |
| DateOfBirth | Description | Subtotal: | $1.00 |
| MRNNumber | Description | Subtotal: | $1.00 |
Request Example:
{
“ClaimPatientParameters”: {
“FirstName”: “John”,
“LastName”: “Doe”,
“HealthCardNumber”: “1234567890”,
“VersionCode”: null,
“Province”: null,
“Gender”: “M”,
“DateOfBirth”: “1988-04-16T00:00:00”,
“MRNNumber”: null,
“PaymentProgram”: “HCP”
},
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”,
“BillingNumber”: “123456”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| PatientId | number | The Id of the patient that was just created |
Response Example:
{“PatientId”:202086}
UpdatePatient Back to Request Dictionary
Type: POST
URL: /PatientAPI/UpdatePatient
Description: Updates an existing patient
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| PatientId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this patient belongs to |
| PatientId | number | Yes | The Patient Id of the patient to be updated |
| FirstName | String | Yes | Maximum of 50 characters |
| LastName | String | Yes | Maximum of 50 characters |
| HealthCardNumber | String | Yes | Healthcard number of the patient. Must be a minimum of 8 numbers to a maximum of 12 numbers. This field handles Ontario and non-Ontario (i.e. RMB claims) health card numbers |
| PaymentProgram | String | Yes | Must be one of the following values: HCP (most common), WCB (Worker’s Compensation Board) or RMB (Reciprocal Medical Billing. Represents non-Ontario patients) |
| VersionCode | String | No | Version code of the Ontario health card if the health card has one. Must be one or two characters in length (i.e. FF) |
| Province | String | No | Not required if the patient has an Ontario health card. Required if the patient is a non-Ontario resident. Allowed values are AB, BC, MB, NB, NL, NS, NT, NU, ON, PE, SK, YT |
| Gender | String | Yes | Must be either M (Male) or F (Female) |
| DateOfBirth | Date | Yes | Date of birth of the patient. Must be in the format of dd/mm/yyyy |
| MRNNumber | String | No | Represents the Medical Record Number of the hospital. Can be a maximum of 15 characters |
Request Example:
{
“ClaimPatientParameters”: {
“PatientId”: 123,
“FirstName”: “John”,
“LastName”: “Doe”,
“HealthCardNumber”: “1234567890”,
“VersionCode”: null,
“Province”: null,
“Gender”: “M”,
“DateOfBirth”: “1988-04-16T00:00:00”,
“MRNNumber”: null,
“PaymentProgram”: “HCP”
},
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”,
“BillingNumber”: “123456”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| PatientId | Number | The Id of the patient that was just created |
Response Example:
{“PatientId”:202086}
DeletePatient Back to Request Dictionary
Type: POST
URL: /PatientAPI/DeletePatient
Description: Deletes an existing patient. Please note that this patient must not have any associated claims. If they do, the claims must be deleted first.
Request Definition:
<
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this patient belongs to |
| PatientId | number | Yes | The Patient Id of the patient to be deleted |
Request Example:
{
“PatientId”: 123,
“BillingNumber”: “123456”,
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| IsPatientDeleted | Boolean | A flag that indicates if the patient was successfully deleted |
Request Example:
{“IsPatientDeleted”:true}
GetPatientById Back to Request Dictionary
Type: GET
URL: /PatientAPI/GetPatientById
Description: Retrieves an existing patient.
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this patient belongs to |
| PatientId | Number | Yes | The Patient Id of the patient to be retrieved |
Request Example:
/api/PatientAPI/GetPatientById?TokenId=9de25a64-4108-4e74-80d4-85b727e2c333& BillingNumber=123456& PatientId=123
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| PatientId | Number | |
| FirstName | String | |
| LastName | String | |
| HealthCardNumber | String | |
| PaymentProgram | String | |
| VersionCode | String | |
| Province | String | Contains null if the patient is from Ontario |
| Gender | String | |
| DateOfBirth | Date | |
| MRNNumber | String | |
| LastReferringPhysician | String | It contains the 6 digit billing number of the last referring physician used for the most recent claim for this patient. May be null if this patient does not have any claims or no referring physician was used |
Response Example:
{PatientId”:123,”FirstName”:”John”,”LastName”:”Doe”,”HealthCardNumber”:”1234567890″,”PaymentProgram”:”HCP”,”VersionCode”:null,”Province”:null,”Gender”:”M”,”DateOfBirth”:”1988-04-16T00:00:00″,”MRNNumber”:null,”LastReferringPhysician”:null}
CreateMOHGroup Back to Request Dictionary
Type: POST
URL: /MOHGroupAPI/CreateMOHGroup
Description: Creates a new Ministry of Health Group for the physician. An error is returned if the group already exists
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this patient belongs to |
| MOHGroup | String | Yes | Ministry of Health assigned group identifier to be created. Must be 4 characters in length |
Request Example:
{
“MOHGroup”: “ABCD”,
“BillingNumber”: “123456”,
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| IsMOHGroupCreated | Boolean | A flag that indicates if the group was created successfully |
Response Example:
{“IsMOHGroupCreated”:true}
GetMOHGroups Back to Request Dictionary
Type: GET
URL: /MOHGroupAPI/GetMOHGroups
Description: Retrieves a list of the physician’s Ministry of Health groups
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician |
Request Example:
/api/MOHGroupAPI/GetMOHGroups?TokenId=9de25a64-4108-4e74-80d4-85b727e2c333& BillingNumber=123456
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| Array of UserMOHGroup items: | ||
| MOHGroup | String |
Response Example:
{“UserMOHGroups”:[{“MOHGroup”:”1234″},{“MOHGroup”:”4567″},{“MOHGroup”:”ABCD”},{“MOHGroup”:”EFGH”}]}
DeleteMOHGroup Back to Request Dictionary
Type: POST
URL: /MOHGroupAPI/DeleteMOHGroup
Description: Deletes a new Ministry of Health Group for the physician. An error is returned if the group does not exist
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this Ministry of Health group belongs to |
| MOHGroup | String | Yes | Ministry of Health assigned group identifier to be created. Must be 4 characters in length |
Request Example:
{
“MOHGroup”: “ABCD”,
“BillingNumber”: “123456”,
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| IsMOHGroupDeleted | Boolean | A flag that indicates if the group was deleted successfully |
Response Example:
{“IsMOHGroupDeleted”:true}
CreateClaim Back to Request Dictionary
Type: POST
URL: /ClaimAPI/CreateClaim
Description: Creates a new claim
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this claim belongs to |
| PatientId | Number | Yes | The Id of the patient that this claim belongs to |
| AdmissionDate | Date | No | The admission date of the patient for the claim. If it is sent, it must be in the format dd/mm/yyyy |
| ServiceLocationIndicator | String | No | The service location indicator code for the claim. Accepted values are HDS, HED, HIP, HOP, HRP, OTN, IHF, OFF |
| ReferringPhysician | String | No | The 6 digit number of the referring physician |
| Payee | String | Yes | Must be P or S. For almost all claims, the value is generally P, which means a payment to the physician. A value of S means a payment to the Ministry of Health |
| MOHGroup | String | No | The 4 character Ministry of Health assigned group |
| LabLicense | String | No | The 4 character laboratory license |
| SpecialtyCode | Number | No | The specialty code used for the claim. A specialty code is a two-digit code that defines a physician’s discipline. For example, the value of 13 represents internal medicine. If no value is sent in, then the physician’s default specialty will be used |
| FacilityNumber | Number | No | The Ministry of Health assigned facility number. This number is assigned to facilities recognized by the Ministry of Health (i.e hospitals, institutions, etc.). Not required if the patient was seen at a clinic |
| Status | String | Yes | The status of the claim. Must be either SAVED (will not be submitted, but can be edited later) or SUBMIT (the claim is ready to be submitted to the Ministry of Health) |
| ManualReview | Boolean | Yes | A flag that indicates whether or not this claim needs to be manually reviewed by a claim assessor. For most claims, this value is false |
| Array of ClaimService items | |||
| ServiceCode | String | Yes | The 5 character billing code associated with the claim. For example, A135A |
| ServiceDate | Date | Yes | The date the service was performed. Must be in the format dd/mm/yyyy |
| DiagnosticCode | String | No | The 3 or 4 characters diagnostic code of the service. For example, 402 |
| Quantity | Number | No | The quantity of this service was performed. This value required if no start and end time has been included. If a start time and end time have been included, this value must be blank. Must be a minimum of 1 to a maximum of 99 |
| AddBasicUnits | Boolean | Yes | A flag that determines if the basic units associated with the service code should be added to the total quantity. A value of true indicates that the basic units should be used and mdbilling.ca will retrieve the associated basic units according to the code and add it to the quantity. This flag is generally associated with anesthesia or surgical assistant codes |
| Fee | Number | No | The unit fee associated with the service. If no value is sent, then mdbilling.ca will retrieve the fee internally and use that value. Must be a minimum of 0.01 to a maximum of 9999.99 |
| StartTime | String | No | The start time of the service. If specified, the total quantity of the service is based on the end time subtracting the start time. Must be in the format of hh:mm. Required if no quantity has been specified. This is generally used for anesthesia or surgical assistant codes |
| EndTime | String | No | The end time of the service. If specified, the total quantity of the service is based on the end time subtracting the start time. Must be in the format of hh:mm. Required if no quantity has been specified. This is generally used for anesthesia or surgical assistant codes |
| ParentServices | String | No | A comma-delimited string of parent service codes. This list is associated with the current service code wherein the code is a percentage premium. The codes in this list must be present and must have the same service date |
Request Example:
{
“ClaimParameters”: {
“AdmissionDate”: null,
“ServiceLocationIndicator”: null,
“ReferringPhysician”: null,
“Payee”: “P”,
“MOHGroup”: null,
“LabLicense”: null,
“SpecialtyCode”: null,
“FacilityNumber”: null,
“FacilityDescription”: null,
“Status”: “SAVED”,
“ManualReview”: false
},
“PatientId”: 201969,
“ClaimServicesParameters”: [
{
“ServiceCode”: “A135A”,
“ServiceDate”: “2013-03-14T00:00:00”,
“DiagnosticCode”: “600”,
“Quantity”: 1,
“AddBasicUnits”: false,
“Fee”: null,
“StartTime”: null,
“EndTime”: null,
“ParentServices”: null
}
],
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”,
“BillingNumber”: “123456”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| ClaimId | Number | The Id of the claim that was just created |
Response Example:
{“ClaimId”:456}
CreateClaimWithPatient Back to Request Dictionary
Type: POST
URL: /ClaimAPI/CreateClaim
Description: Creates a new claim and a new patient at the same time. The patient must not already exist
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this claim belongs to |
| PatientId | Number | Yes | The Id of the patient that this claim belongs to |
| ClaimPatientParameters | |||
| FirstName | String | Yes | Maximum of 50 characters |
| LastName | String | Yes | Maximum of 50 characters |
| HealthCardNumber | String | Yes | Healthcard number of the patient. Must be a minimum of 8 numbers to a maximum of 12 numbers. This field handles Ontario and non-Ontario (i.e. RMB claims) health card numbers |
| PaymentProgram | String | Yes | Must be one of the following values: HCP (most common), WCB (Worker’s Compensation Board) or RMB (Reciprocal Medical Billing. Represents non-Ontario patients) |
| VersionCode | String | No | Version code of the Ontario health card if the health card has one. Must be one or two characters in length (i.e. FF) |
| Province | String | No | Not required if the patient has an Ontario health card. Required if the patient is a non-Ontario resident. Allowed values are AB, BC, MB, NB, NL, NS, NT, NU, ON, PE, SK, YT |
| Gender | String | Yes | Must be either M (Male) or F (Female) |
| DateOfBirth | date | Yes | Date of birth of the patient. Must be in the format of dd/mm/yyyy |
| MRNNumber | String | No | Represents the Medical Record Number of the hospital. Can be a maximum of 15 characters |
| ClaimParameters | |||
| AdmissionDate | Date | No | The admission date of the patient for the claim. If it is sent, it must be in the format dd/mm/yyyy |
| ServiceLocationIndicator | String | No | The service location indicator code for the claim. Accepted values are HDS, HED, HIP, HOP, HRP, OTN, IHF, OFF |
| ReferringPhysician | String | No | The 6 digit number of the referring physician |
| Payee | String | Yes | Must be P or S. For almost all claims, the value is generally P, which means a payment to the physician. A value of S means a payment to the Ministry of Health |
| MOHGroup | String | No | The 4 character Ministry of Health assigned group |
| LabLicense | String | No | The 4 character laboratory license |
| SpecialtyCode | Number | No | The specialty code used for the claim. A specialty code is a two-digit code that defines a physician’s discipline. For example, the value of 13 represents internal medicine. If no value is sent in, then the physician’s default specialty will be used |
| FacilityNumber | Number | No | The Ministry of Health assigned facility number. This number is assigned to facilities recognized by the Ministry of Health (i.e hospitals, institutions, etc.). Not required if the patient was seen at a clinic |
| Status | String | Yes | The status of the claim. Must be either SAVED (will not be submitted, but can be edited later) or SUBMIT (the claim is ready to be submitted to the Ministry of Health) |
| ManualReview | Boolean | Yes | A flag that indicates whether or not this claim needs to be manually reviewed by a claim assessor. For most claims, this value is false |
| Array of ClaimServiceParameters items | |||
| ServiceCode | String | Yes | The 5 character billing code associated with the claim. For example, A135A |
| ServiceDate | Date | Yes | The date the service was performed. Must be in the format dd/mm/yyyy |
| DiagnosticCode | String | No | The 3 or 4 characters diagnostic code of the service. For example, 402 |
| Quantity | Number | No | The quantity of this service was performed. This value required if no start and end time has been included. If a start time and end time have been included, this value must be blank. Must be a minimum of 1 to a maximum of 99 |
| AddBasicUnits | Boolean | Yes | A flag that determines if the basic units associated with the service code should be added to the total quantity. A value of true indicates that the basic units should be used and mdbilling.ca will retrieve the associated basic units according to the code and add it to the quantity. This flag is generally associated with anesthesia or surgical assistant codes |
| Fee | Number | No | The unit fee associated with the service. If no value is sent, then mdbilling.ca will retrieve the fee internally and use that value. Must be a minimum of 0.01 to a maximum of 9999.99 |
| StartTime | String | No | The start time of the service. If specified, the total quantity of the service is based on the end time subtracting the start time. Must be in the format of hh:mm. Required if no quantity has been specified. This is generally used for anesthesia or surgical assistant codes |
| EndTime | String | No | The end time of the service. If specified, the total quantity of the service is based on the end time subtracting the start time. Must be in the format of hh:mm. Required if no quantity has been specified. This is generally used for anesthesia or surgical assistant codes |
| ParentServices | String | No | A comma-delimited string of parent service codes. This list is associated with the current service code wherein the code is a percentage premium. The codes in this list must be present and must have the same service date |
Request Example:
{
“ClaimParameters”: {
“AdmissionDate”: null,
“ServiceLocationIndicator”: null,
“ReferringPhysician”: null,
“Payee”: “P”,
“MOHGroup”: null,
“LabLicense”: null,
“SpecialtyCode”: null,
“FacilityNumber”: null,
“FacilityDescription”: null,
“Status”: “SAVED”,
“ManualReview”: false
},
“ClaimPatientParameters”: {
“FirstName”: “createclaimtest”,
“LastName”: “mctest”,
“HealthCardNumber”: “6888899990”,
“VersionCode”: null,
“Province”: null,
“Gender”: “M”,
“DateOfBirth”: “1988-04-16T00:00:00”,
“MRNNumber”: null,
“PaymentProgram”: “HCP”
},
“ClaimServicesParameters”: [
{
“ServiceCode”: “A135A”,
“ServiceDate”: “2013-03-14T00:00:00”,
“DiagnosticCode”: “600”,
“Quantity”: 1,
“AddBasicUnits”: false,
“Fee”: null,
“StartTime”: null,
“EndTime”: null,
“ParentServices”: null
}
],
“BillingNumber”: “123456”,
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| ClaimId | number | The Id of the claim that was just created |
| PatientId | number | The Id of the patient that was just created |
Response Example:
{“PatientId”:123,”ClaimId”:456}
UpdateClaimBack to Request Dictionary
Type: POST
URL: /ClaimAPI/UpdateClaim
Description: Updates an existing claim. Only claims with a status of saved or rejected can be updated
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this claim belongs to |
| ClaimId | Number | Yes | Claim Id of the claim to be updated |
| PatientId | Number | Yes | The Id of the patient that this claim belongs to |
| AdmissionDate | Date | No | The admission date of the patient for the claim. If it is sent, it must be in the format dd/mm/yyyy |
| ServiceLocationIndicator | String | No | The service location indicator code for the claim. Accepted values are HDS, HED, HIP, HOP, HRP, OTN, IHF, OFF |
| ReferringPhysician | String | No | The 6 digit number of the referring physician |
| Payee | String | Yes | Must be P or S. For almost all claims, the value is generally P, which means a payment to the physician. A value of S means a payment to the Ministry of Health |
| MOHGroup | String | No | The 4 character Ministry of Health assigned group |
| LabLicense | String | No | The 4 character laboratory license |
| SpecialtyCode | Number | No | The specialty code used for the claim. A specialty code is a two-digit code that defines a physician’s discipline. For example, the value of 13 represents internal medicine. If no value is sent in, then the physician’s default specialty will be used |
| FacilityNumber | Number | No | The Ministry of Health assigned facility number. This number is assigned to facilities recognized by the Ministry of Health (i.e hospitals, institutions, etc.). Not required if the patient was seen at a clinic |
| Status | String | Yes | The status of the claim. Must be either SAVED (will not be submitted, but can be edited later) or SUBMIT (the claim is ready to be submitted to the Ministry of Health) |
| ManualReview | Boolean | Yes | A flag that indicates whether or not this claim needs to be manually reviewed by a claim assessor. For most claims, this value is false |
| Array of ClaimService items | |||
| ServiceCode | String | Yes | The 5 character billing code associated with the claim. For example, A135A |
| ServiceDate | Date | Yes | The date the service was performed. Must be in the format dd/mm/yyyy |
| DiagnosticCode | String | No | The 3 or 4 characters diagnostic code of the service. For example, 402 |
| Quantity | Number | No | The quantity of this service was performed. This value required if no start and end time has been included. If a start time and end time have been included, this value must be blank. Must be a minimum of 1 to a maximum of 99 |
| AddBasicUnits | Boolean | Yes | A flag that determines if the basic units associated with the service code should be added to the total quantity. A value of true indicates that the basic units should be used and mdbilling.ca will retrieve the associated basic units according to the code and add it to the quantity. This flag is generally associated with anesthesia or surgical assistant codes |
| Fee | Number | No | The unit fee associated with the service. If no value is sent, then mdbilling.ca will retrieve the fee internally and use that value. Must be a minimum of 0.01 to a maximum of 9999.99 |
| StartTime | String | No | The start time of the service. If specified, the total quantity of the service is based on the end time subtracting the start time. Must be in the format of hh:mm. Required if no quantity has been specified. This is generally used for anesthesia or surgical assistant codes |
| EndTime | String | No | The end time of the service. If specified, the total quantity of the service is based on the end time subtracting the start time. Must be in the format of hh:mm. Required if no quantity has been specified. This is generally used for anesthesia or surgical assistant codes |
| ParentServices | String | No | A comma-delimited string of parent service codes. This list is associated with the current service code wherein the code is a percentage premium. The codes in this list must be present and must have the same service date |
Request Example:
{
“ClaimParameters”: {
“AdmissionDate”: null,
“ServiceLocationIndicator”: null,
“ReferringPhysician”: null,
“Payee”: “P”,
“MOHGroup”: null,
“LabLicense”: null,
“SpecialtyCode”: null,
“FacilityNumber”: null,
“FacilityDescription”: null,
“Status”: “SAVED”,
“ManualReview”: false
},
“PatientId”: 123,
“ClaimId”: 456,
“ClaimServicesParameters”: [
{
“ServiceCode”: “A133A”,
“ServiceDate”: “2013-03-14T00:00:00”,
“DiagnosticCode”: “600”,
“Quantity”: 1,
“AddBasicUnits”: false,
“Fee”: null,
“StartTime”: null,
“EndTime”: null,
“ParentServices”: null
}
],
“TokenId”: “9de25a64-4108-4e74-80d4-85b727e2c333”,
“BillingNumber”: “123456”
}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| ClaimId | number | The Id of the claim that was just updated |
Response Example:
{“ClaimId”:456}
DeleteClaim Back to Request Dictionary
Type: POST
URL: /ClaimAPI/DeleteClaim
Description: Deletes an existing claim. Only claims with a status of saved or unsubmitted can be deleted
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician to which this claim belongs to |
| ClaimId | Number | Yes | Claim Id of the claim to be deleted |
Request Example:
{“ClaimId”:456,”BillingNumber”:”123456″,”TokenId”:”9de25a64-4108-4e74-80d4-85b727e2c333″}
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| IsClaimDeleted | Boolean | A flag that indicates if the claim was successfully deleted |
Response Example:
{“IsClaimDeleted”:true}
FindClaimsBack to Request Dictionary
Type: GET
URL: /ClaimAPI/FindClaims
Description: Gets a list of claims based on search parameters. A maximum of 50 results are returned.
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician |
| AccountingId | Number | No | Mdbilling.ca assigned accounting Id |
| PatientId | Number | No | Id of a patient |
| ClaimStatus | String | No | If included, must be one of the following values: saved, submitted, unsubmitted, paid, adjusted payment, rejected or archived |
Request Example:
/api/ClaimAPI/FindClaims?TokenId=9de25a64-4108-4e74-80d4-85b727e2c333&BillingNumber=123456&ClaimStatus=saved
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| Array of ClaimSearchResult items | ||
| ClaimId | Number | |
| AccountingId | Number | |
| PatientId | Number | |
| PatientName | String | |
| MOHBatchNumber | Number | Only sent if the claim has a batch number assigned by the ministry |
| ClaimStatus | String | |
| ClaimValue | Number | The total value of the claim |
| ClaimDate | Date | Date of the claim based on the service dates. If there is more than one service date associated with the claim, the most recent date is used |
Response Example:
{
“ClaimSearchResults”: [
{
“ClaimId”: 456,
“AccountingId”: 111,
“PatientId”: 123,
“PatientName”: “Doe, John”,
“MOHBatchNumber”: null,
“ClaimStatus”: “Saved”,
“ClaimValue”: 157,
“ClaimDate”: “2013-03-14T00:00:00”
},
{
“ClaimId”: 789,
“AccountingId”: 222,
“PatientId”: 369,
“PatientName”: “Smith, Adam”,
“MOHBatchNumber”: null,
“ClaimStatus”: “Saved”,
“ClaimValue”: 91.88,
“ClaimDate”: “2013-03-14T00:00:00”
}
]
}
GetClaimByClaimIdBack to Request Dictionary
Type: GET
URL: /ClaimAPI/GetClaimByClaimId
Description: Gets a claim by it’s Id.
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician |
| ClaimId | Number | Yes | Id of the claim to be retrieved |
Request Example:
/api/ClaimAPI/GetClaimByClaimId?TokenId=9de25a64-4108-4e74-80d4-85b727e2c333&BillingNumber=123456&ClaimId=456
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| ClaimParameters | ||
| ClaimId | Number | |
| AccountingId | Number | |
| PatientId | Number | |
| AdmissionDate | Date | |
| ServiceLocationIndicator | String | |
| ReferringPhysician | String | |
| Payee | String | |
| MOHGroup | String | |
| LabLicense | String | |
| SpecialtyCode | Number | |
| FacilityNumber | Number | |
| FacilityDescription | String | |
| Status | String | |
| ManualReview | Boolean | |
| ClaimPatientParameters | Number | |
| FirstName | String | |
| LastName | String | |
| HealthCardNumber | String | |
| PaymentProgram | String | |
| VersionCode | String | |
| Province | String | |
| Gender | String | |
| DateOfBirth | Date | |
| MRNNumber | String | |
| Array of ClaimServicesParameters | ||
| ServiceCode | String | |
| ServiceDate | Date | |
| DiagnosticCode | String | |
| Quantity | Number | |
| AddBasicUnits | Boolean | |
| Fee | Number | |
| StartTime | String | |
| EndTime | String | |
| AmountSubmitted | Number | Only shows with PAID and ADJUSTEDPAYMENT claims |
| AmountPaid | Number | Only shows with PAID and ADJUSTEDPAYMENT claims |
| PaymentDate | Date | Only shows with PAID and ADJUSTEDPAYMENT claims |
| ParentServices | String | Comma-delimited list of parent service codes |
| RemittanceAdjustments | Array of RemittanceAdjustment | Only shows with ADJUSTEDPAYMENT claims. When doing calculations, these adjustments need to be applied to the AmountPaid value
Each RemittanceAdjustment consists of: Amount (left blank if it was added by MOH) |
Response Example:
{
“ClaimParameters”: {
“ClaimId”: 456,
“AccountingId”: 111,
“PatientId”: 123,
“AdmissionDate”: null,
“ServiceLocationIndicator”: null,
“ReferringPhysician”: null,
“Payee”: “P”,
“MOHGroup”: null,
“LabLicense”: null,
“SpecialtyCode”: 3,
“FacilityNumber”: null,
“FacilityDescription”: null,
“Status”: “ADJUSTEDPAYMENT”,
“ManualReview”: false
},
“ClaimPatientParameters”: {
“PatientId”: 123,
“FirstName”: “John”,
“LastName”: “Doe”,
“HealthCardNumber”: “1234567890”,
“PaymentProgram”: “HCP”,
“VersionCode”: null,
“Province”: null,
“Gender”: “M”,
“DateOfBirth”: “1988-04-16T00:00:00”,
“MRNNumber”: null,
“LastReferringPhysician”: null
},
“ClaimServicesParameters”: [
{
“ServiceCode”: “A134A”,
“ServiceDate”: “2013-03-14T00:00:00”,
“DiagnosticCode”: “600”,
“Quantity”: 1,
“AddBasicUnits”: false,
“Fee”: 61.25,
“StartTime”: null,
“EndTime”: null,
“AmountSubmitted”: 100.00
“AmountPaid”: 100.00
“PaymentDate”: “2013-04-15T00:00:00”,
“ParentServices”: null
},
{
“ServiceCode”: “A133A”,
“ServiceDate”: “2013-03-14T00:00:00”,
“DiagnosticCode”: “600”,
“Quantity”: 1,
“AddBasicUnits”: false,
“Fee”: 79.85,
“StartTime”: null,
“EndTime”: null,
“AmountSubmitted”: 80.00
“AmountPaid”: 80.00
“PaymentDate”: “2013-04-15T00:00:00”,
“ParentServices”: null
“RemittanceAdjustments”: [
{
“Amount”: “”,
“AdjustmentDate”: “2013-05-15T00:00:00”,
“AdjustmentType”: “Service added by MOH”,
} ] },
{
“ServiceCode”: “E078A”,
“ServiceDate”: “2013-03-14T00:00:00”,
“DiagnosticCode”: “600”,
“Quantity”: 1,
“AddBasicUnits”: false,
“Fee”: 70.55,
“StartTime”: null,
“EndTime”: null,
“AmountSubmitted”: 80.00
“AmountPaid”: 20.00
“PaymentDate”: “2013-04-15T00:00:00”,
“ParentServices”: “A134A,A133A”
, “RemittanceAdjustments”: [
{
“Amount”: “30.00”,
“AdjustmentDate”: “2013-05-15T00:00:00”,
“AdjustmentType”: “Positive Adjustment”,
},
{
“Amount”: “-10.00”,
“AdjustmentDate”: “2013-06-15T00:00:00”,
“AdjustmentType”: “Negative Adjustment”,
} ]
}
]
}
GetQuantityFromTimeBack to Request Dictionary
Type: GET
URL: /ClaimAPI/GetQuantityFromTime
Description: Gets the quantity based on a start time, end time and a service code. Used for anesthesia and surgical assistant codes
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician |
| ServiceCode | String | Yes | The 5 character service code to apply to calculate the start and end times against |
| StartTime | String | Yes | Start time of the service. Must be in the format hh:mm |
| EndTime | String | Yes | The end time of the service. Must be in the format hh:mm |
Request Example:
/api/ClaimAPI/GetQuantityFromTime? TokenId=9de25a64-4108-4e74-80d4-85b727e2c333&BillingNumber=123456&ServiceCode=D001C&StartTime=09:00&EndTime=13:30
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| Quantity | Number |
Response Example:
{“Quantity”:44}
FindFacility Back to Request Dictionary
Type: GET
URL: /ClaimAPI/FindFacility
Description: Retrieves Ministry of Health recognized facilities based on a search string
Request Definition:
| Parameter (s) | Data Type | Required? | Comment |
|---|---|---|---|
| TokenId | GUID | Yes | mdbilling.ca assigned token |
| BillingNumber | String | Yes | Billing number of the physician |
| FacilitySearchValue | String | Yes | The search string to find facilities. Maximum of 100 characters |
Request Example:
/api/ClaimAPI/FindFacility? TokenId=9de25a64-4108-4e74-80d4-85b727e2c333&BillingNumber=123456&FacilitySearchValue=sunny
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| Array of FacilityResult items | ||
| FacilityId | Number | Ministry of Health assigned facility identifier |
| FacilityDescription | String | Description of the facility. Mimics the same format used when searching a facility on mdbilling.ca’s site |
Response Example:
{
“FacilityResults”: [
{
“FacilityId”: 1647,
“FacilityDescription”: “1647 SUNNYCREST NURSING HOME WHITBY (NH)”
},
{
“FacilityId”: 1923,
“FacilityDescription”: “1923 SUNNYSIDE HOME KITCHENER (HF)”
},
{
“FacilityId”: 2400,
“FacilityDescription”: “2400 SUNNYBROOK HEALTH SCIENCES CENTRE (NH)”
},
{
“FacilityId”: 3312,
“FacilityDescription”: “3312 SUNNYBROOK HEALTH SCIENCES CENTRE TORONTO (SO)”
},
{
“FacilityId”: 3936,
“FacilityDescription”: “3936 SUNNYBROOK HEALTH SCIENCES CENTRE TORONTO (AT)”
},
{
“FacilityId”: 3937,
“FacilityDescription”: “3937 SUNNYBROOK HEALTH SCIENCES CENTRE TORONTO (CR)”
},
{
“FacilityId”: 3939,
“FacilityDescription”: “3939 SUNNYBROOK HEALTH SCIENCES CENTRE TORONTO (CR)”
},
{
“FacilityId”: 4205,
“FacilityDescription”: “4205 SUNNYBROOK HEALTH SCIENCES CENTRE TORONTO (AM)”
},
{
“FacilityId”: 4273,
“FacilityDescription”: “4273 SUNNYBROOK HEALTH SCIENCES CENTRE TORONTO (GR)”
},
{
“FacilityId”: 4274,
“FacilityDescription”: “4274 SUNNYBROOK HEALTH SCIENCES CENTRE-ORTHOP TORONTO (GR)”
},
{
“FacilityId”: 4577,
“FacilityDescription”: “4577 SUNNYBROOK HEALTH SCIENCES CENTRE TORONTO (MH)”
}
]
}
ErrorsBack to Request Dictionary
For any request, a list of errors can be sent back under the following reasons:
- Incorrect data format
- Failed validation
Errors are returned with an HTTP Bad Request code with the following format:
Response definition:
| Parameter (s) | Data Type | Comment |
|---|---|---|
| Array of Strings | ||
| Error-[X] | String | Combination of error number sequence and message |